| Entity Name: | C3 WELLNESS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 02 Feb 2010 (15 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 03 Nov 2022 (2 years ago) |
| Document Number: | L10000012327 |
| FEI/EIN Number | 274407703 |
| Address: | 1060 cypress parkway, KISSIMMEE, FL, 34759, US |
| Mail Address: | 2717 EAGLE CANYON DRIVE SOUTH, KISSIMMEE, FL, 34746, US |
| ZIP code: | 34759 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811490287 | 2018-03-13 | 2024-08-23 | 2717 EAGLE CANYON DR S, KISSIMMEE, FL, 347463170, US | 395 VILLAGE DR, KISSIMMEE, FL, 347594012, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-914-9168 |
| Fax | 4073378005 |
Authorized person
| Name | MARCUS BETHEA |
| Role | OWNER |
| Phone | 9196066423 |
Taxonomy
| Taxonomy Code | 171100000X - Acupuncturist |
| Is Primary | No |
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
| Taxonomy Code | 225700000X - Massage Therapist |
| License Number | MA58296 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 225X00000X - Occupational Therapist |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 112243500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 113572200 |
| State | FL |
| Issuer | MEDICAID |
| Number | 024831500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Bethea Crystal L | Agent | 2717 EAGLE CANYON DRIVE SOUTH, KISSIMMEE, FL, 34746 |
| Name | Role |
|---|---|
| ARYES ENTERPRISE INC | Managing Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000124002 | C3 WELLNESS SPA | ACTIVE | 2023-10-06 | 2028-12-31 | No data | 2717 EAGLE CANYON DRIVE SOUTH, KISSIMMEE, FL, 34746 |
| G19000072578 | RIVIERA SPA MASSAGE | EXPIRED | 2019-07-01 | 2024-12-31 | No data | 2717 EAGLE CANYON DRIVE SOUTH, KISSIMMEE, FL, 34746 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2022-11-03 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-11-03 | Bethea, Crystal L | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| LC NAME CHANGE | 2022-04-13 | C3 WELLNESS, LLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-15 | 1060 cypress parkway, suite 104, KISSIMMEE, FL 34759 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-23 |
| ANNUAL REPORT | 2023-01-28 |
| REINSTATEMENT | 2022-11-03 |
| LC Name Change | 2022-04-13 |
| ANNUAL REPORT | 2021-03-31 |
| ANNUAL REPORT | 2020-06-18 |
| ANNUAL REPORT | 2019-03-05 |
| ANNUAL REPORT | 2018-01-21 |
| ANNUAL REPORT | 2017-04-16 |
| ANNUAL REPORT | 2016-03-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
